Roses not ashes: Tending to returning soldiers

Dr. Clarissa Pinkola Estés
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May. 19, 2008
El Rio Debajo del Rio

You know how sometimes we don’t know what to say to people who’ve been terribly hurt, shocked or injured by an ongoing trauma? We don’t want to, in any way, accidentally distress them further. So, we might say nothing, and just hope they know our good intentions, that our prayers are with them.

But, long ago, the how-tos about helping injured people were laid out in an ancient document. In the 8th century B.C., an old man poet named Yeša-yáhu, was married to a woman called “The Prophetess,” who no doubt influenced him to the good, for he wrote a wildly compassionate list of how to proceed with people who were strong, but who had also been hurt by being at war, even though they’d finally made it home again.

‘Right off, first thing,’ the old poet said, ‘Believe.’Believe the words, tone of voice, touches needed for helping and healing the wounded will be put into your heart. Believe. Then, proceed within your purview to leave no wounded person stranded.

But in our time, leaving wounded soldiers returned from war stranded seems exactly what the military arm of the U.S. government thinks ought be done.

* * * *

Our government is apparently willing to abandon returning vets from the Iraq and Afghanistan wars by robbing them of adequate aftercare for their post-traumatic stress disorder afflictions. Returning soldiers have been given fake or trivialized diagnoses, which has led to wrong and ineffective treatment. Some have been told that their severe symptoms are “not real,” and they receive no treatment whatsoever.

Estimates of suicides in men and women returning from Iraq and Afghanistan are mind-boggling.

“A five-month CBS News probe, based upon a detailed analysis of data obtained from death records from 2004 and 2005, found that veterans were more than twice as likely to commit suicide in 2005 as non-vets.

If those figures represented an outbreak of cholera, the Centers for Disease Control would alert every doctor, clinic and hospital in the land to take extraordinary measures to intervene immediately until the disorder was beaten back entirely.

But the alarm has not gone out in any sustained manner.

It’s one thing for soldiers to be transported to the other side of the world to fight “the enemy,” only to be torn apart heart and soul by what they see, by what they are ordered to do during deployment -- picking up parts of children blown to bits; trying to staunch unstaunchable bleeding from a buddy’s gut wound; being surrounded by the constant spectre of death from those who care nothing for human life whatsoever. It’s quite another thing to come back home to find another kind of predator, an enemy who cares absolutely nothing for your life recovery, and acts like the old couple in the horror film “Rosemary’s Baby,” the very nice neighbors next door who use code words of kindness and say they want to help you -- but are actually conspiring to do you in.

Last week The Washington Post reported:

A psychologist who helps lead the post-traumatic stress disorder program at a medical facility for veterans in Texas told staff members to refrain from diagnosing PTSD because so many veterans were seeking government disability payments for condition.

“Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out," Norma Perez wrote in a March 20 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Texas. Instead, she recommended that they "consider a diagnosis of Adjustment Disorder."

“VA staff members really don't . . . have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

“Adjustment disorder is a less severe reaction to stress than PTSD and has a shorter duration, usually no longer than six months, said Anthony T. Ng, a psychiatrist member of Mental Health America, a nonprofit professional association.”

Adjustment disorder is a diagnosis that applies to kids who are having a hard time during a change of schools. Adjustment disorder sometimes applies to adults going through a rough transition, say an uncontested divorce.

Post-traumatic stress disorder is like living in unrelieved assault by one’s own horrific memories and night dreams that seem to have a will of their own sometimes; feeling one is no longer quite human or not worthy of being so; having lost meaning in life; having lost ability to enjoin life; thinking one is unworthy of seeking happiness; haunted by after-images; feeling one is useless and doomed; believing no one understands, that one will somehow destroy or degrade anyone who might come near and love them, or who hears their stories. In extreme PTSD, there can be an ultra-isolation, sudden rages that arrive unbidden without obvious triggers, and an encroaching drive to want to destroy oneself in order to make the pain of it all cease.

The difference between adjustment disorder and post-traumatic stress disorder is the difference between being in an uncomfortable, unfamiliar and challenging living space and trying to find one’s way out of a burning building whilst blinded by anger, fear and grief.

Withholding diagnosis, questioning whether symptoms are real, withholding treatments -- these are apparently a U.S. government tradition regarding veterans of previous wars. Consider the Agent Orange claims of Vietnam vets. The government has stonewalled all these years, maintaining there is no link between exposure to this deadly herbicide and a long list of “complaints” from veterans, including, prostate cancer, lung cancer, multiple myeloma, Hodgkin’s disease, soft tissue sarcoma, peripheral neuropathy and spina bifida in children of veterans.

The issue is money. Old man government doesn’t want to pay for injuries young people received when the government put them in harms’ way. An estimated 300,000 troops will need some form of mental recovery care in the next decades. It will cost several billion dollars. The cost of an endless war is endless.

A friend, Shaun Mullen, a Vietnam veteran and also news correspondent during the Vietnam War, said about the scheme to scam returning US soldiers out of sorely needed treatment, “There is a special place in hell for doctors who violate the Hippocratic Oath to save not tortured souls but money.”

But we the believers have a troth with tortured souls. We, the old believers, also have instructions that teach us how to go about compassionate care of the wounded; how to help, even if our own government can’t or wont. Remember that old poet of the 8th century B.C.?

He’d witnessed in his lifetime blood running in the streets as wars launched by Egypt, Assyria and Ethiopia crushed his Judean homeland. Thus, the last many pages of his prophetic poetry are devoted to how to comfort those who had been through battle, loss, and exile -- self-exile and terrible internal battles, included. The old poet’s words went something like this:

How to help those wounded in heart, mind and body by war(an exegesis of Isaiah 61: 1-7[2])

“Right off, first thing,” ‘Believe.’Believe the helpful words, the tone of voice, the healing touches needed, will be put into your heart. Believe you can do it, you can help. Believe. Then, proceed within your purview to leave no wounded person stranded.

Believe “the spirit is upon us,” and thus we’re required, we’re enabled, both, to say brave, uncommon words to those souls so hurt by war they are now, for a time, poor in spirit.

To help heal the heartbroken,

announce over and over in your own way, “Your soul, Beloved, despite all else, is free. You, Beloved, are pardoned from your prison ...”

Since time out of mind, Grace is to be given any soldier returned from any war. Tell the war torn, We are gladdened when any enemy in your mind is vanquished. We row with you toward that end.

And, we will stand by you and give comfort to all your necessary mournings, for as long as it takes.

To give care to the needs of all who mourn, Let armfuls of love, beautiful sights and words all bound together like roses, fall over the tired mind ... the wounded already have ashes enough. Carry messages that point out where joys lurk nearby just hoping to be embraced, and turn away from joining in to harp about how cold this old world has become.

Bring to the suffering a clear example of a praising heart instead of a listless spirit, and the wounded will slowly begin to remember their own praising heart. Tell them, in your heart or out loud that you will rename them away from whatever awful names they’ve thought up for themselves. That instead, you’ll name them a name to grow on, one they were born to live. In whatever way, their true name is "Oak of Righteousness" planted by One greater, made for showing the fineness, the fitness of the Work. Tell them, The Work is you, and it has always been so, has never been lost, but only covered over... is still hale, still present, still fully alive.

Convey in some way to the wounded, Together, we’ll rebuild from your old ruins. We’ll raise a new self out of the wreckage. We'll start over on those ruined cities within your heart. We’ll take the rubble left behind and make a strong, habitable place from the old. Tell the suffering: You'll find others to help you increase your life. Yes your life will always have some foreign element in it now. Don’t be surprised though if strangers come to help you in your soul’s work.

Tell the injured: You will become a teller of stories and glories, too, honored as a keeper of an ancient ideal; and most of all, You’ll be happy again ... happy about the good that happens to others, as well as the good that comes to you. Let the war torn know that you know they’ve had a double dose of torments, And more than their share of contempt, and that now is time to Rest, rebuild now. Tell them: The land inside you has been made deep, and doubled in some good way, and it is safe here now, and you will be happy again.

CODA

How to help:

Depending on which part of the country the veteran lives in, the waiting time to see a shrink can be anywhere from six weeks to six months. There is a dearth of those who can give psychological help, but there are also other needs. If you would like to help returning vets, you can help fill out paperwork, retrieve lost forms, drive people to doctors appointments, and press the techs in charge of health appointments to see the patient as soon as possible. You can also visit and listen to the returning soldiers.

I have been told that even when a vet feels suicidal, it can take up to 10 days before he or she is seen. The military has said they are instituting a suicide help line, but many soldiers may not know about it. Those afflicted often give up when the multiple military ganglion of phone reps becomes too hard to navigate. You can help by volunteering to be, as my grandmother used to say, “a small-town Maria,” an “act-where-I-live Mary,” one who helps others from home; either a physical or virtual gathering place of those individuals or groups seeking help for vets and vets’ families. Look into the model of “Peace Villages” in Vietnam, for inspiration about what can be done in small communities here.

Also helpful:

The military currently estimates over 300,000 returning soldiers have depression, PTSD or other brain injuries, not including other bodily injuries. You can help by supporting and befriending families of soldiers. Spouses, parents, grandparents and siblings worry so much about their loved ones.

Additional helps:

You can call the military base or VA hospital nearest you. Hang in there, it’s often a many layered process to get through to the right people. Ask for Volunteer Services or their equivalent. Also, inquire at your local Quaker group or your parish or your church group to see if they have a veterans outreach program or mission/shelter outreach. Google, as always, in cases like these, is your good friend. In my own re-upping as a VA volunteer recently, I found the section I’d like to work in, now requires a full Federal security clearance. As far as I can tell, they won’t count parking tickets against you.

So many ways to pray:

If you see a vet in your neighborhood or family circle who seems to be locked into themselves, you can talk to them as you would anyone. Ask, How you are doing? They’ll likely say, Alright. Don’t stop there if your intuition leads you to remain near. Ask once more, How you really doing? They may tell you, and you can go from there. They may not tell you the real deal. Respect that. But keep greeting them warmly no matter how they react, treating them as you would any other person. Something in them, something of the soul is watching you and hearing you, even if the person cannot respond yet. Alienation is a big issue amongst many returning vets; self-alienation, and also feeling alienated by others who don’t mean to, but who often don’t know quite what to say, and think to leave well enough alone.

Don’t leave “well enough” alone. The person suffering is likely not “well enough” to be left alone yet. We have, after all, remember, the old poet’s guidelines to follow.